Goals of Treating Periodontal Disease
In most cases, dogs with periodontal disease will need to be placed under general anesthesia for a complete dental examination and treatment, which may include cleaning above and below the gum line, scaling, polishing and extracting badly decayed teeth. The goals of treating canine periodontal disease are to remove and control accumulations of plaque and calculus, extract those teeth that are irreparably damaged, prevent loss of the attachment between teeth and bone and prevent further progression of the disease.
Dogs with periodontal disease typically will be put under heavy sedation or general anesthesia, both for their own comfort and to allow the attending veterinarian to clean, scale, probe and polish all of their teeth and assess the nature and extent of gingivitis, periodontitis and tooth looseness or loss. Ultrasonic dental equipment similar to that used by human dentists is increasingly available to veterinary practitioners. These fairly routine examinations and procedures usually effectively remove all but the deepest accumulations of plaque and calculus. Antibiotic gel may also be applied to promote recovery.
A number of surgical techniques, including gingival flaps, bone replacement and bone augmentation, are available to help a dog retain severely affected teeth that have deep gingival pockets around them but are not excessively loose. A gingivectomy is a surgical procedure that can be performed to remove loose, infected and diseased gum tissue. Splints can be surgically installed around affected teeth, especially around the incisors, to help stabilize mobile teeth. The attending veterinarian will probably recommend removal of teeth that are extremely unstable or are no longer attached to underlying bone. Ultimately, tooth extraction is the only reliable treatment for dogs with advanced periodontal disease.
After treatment, owners should start a regular oral hygiene regimen for their dog, to reduce the risk of further oral disease. This may include brushing, using toothpastes and gels and washing or rinsing with other recommended canine oral products, which a veterinarian can recommend. Fluoride and Chlorhexidine are among the most effective topical products for reducing plaque formation and bacterial build-up, although they should not be used at the same time in most cases. Oral antibiotics may be prescribed for a week or so before and after dental procedures to reduce the risk of systemic infection. Sustained release veterinary products that are applied to the dog’s gums may also be available. Vaccines against the primary bacteria found to proliferate in dogs with periodontitis are under development.
The prognosis for dogs with periodontal disease is highly variable, depending upon the stage of the disease and the dog’s immune status, among other things. The prognosis is good to excellent if the owner is conscientious about regular dental care and inpatient treatment and management procedures. If periodontal disease is not properly diagnosed and effectively treated, the bacteria that proliferate in dental plaque and gum pockets can enter the bloodstream and migrate to distant organs. This can lead to bacteremia and septicemia, conditions which can be extremely dangerous and potentially fatal to domestic dogs.